Wang Yiheng, Yu Jinlu
Department of Neurosurgery, First Hospital of Jilin University, Changchun, China.
Front Neurol. 2022 Jul 5;13:895527. doi: 10.3389/fneur.2022.895527. eCollection 2022.
Vertebrobasilar dolichoectasia (VBD) is characterized by significant expansion, elongation, and tortuosity of the basilar artery and vertebral artery. Certain highly selected cases of VBD can require intervention. Recent advances in endovascular treatment (EVT) have renewed hope for patients with VBD. However, which cases of VBD can benefit from EVT still needs to be determined. Currently, little is known regarding this matter. Therefore, we performed a review of the literature from a PubMed search and cataloged our experience regarding the classification and natural history of VBD and the prospects, prognosis and complications of EVT. The findings can be summarized as follows: for asymptomatic VBD, "wait and see" or medical management may be a reasonable strategy. EVT may only be effective in certain patients. For saccular aneurysms in VBD, especially ruptured aneurysms, EVT is reasonable. For fusiform aneurysms in VBD, EVT can carry high complication rates and should be recommended with caution. For stenting reconstruction in VBD, the effect is uncertain. For the future of EVT of VBD, randomized controlled trials and the development of neurointerventional products are worth pursuing, but EVT in VBD still has a long way to go.
椎基底动脉延长扩张症（VBD）的特征是基底动脉和椎动脉显著扩张、延长及迂曲。某些经过严格筛选的VBD病例可能需要进行干预。血管内治疗（EVT）的最新进展为VBD患者带来了新的希望。然而，哪些VBD病例能从EVT中获益仍有待确定。目前，对此知之甚少。因此，我们通过PubMed搜索对文献进行了综述，并整理了我们关于VBD的分类、自然病史以及EVT的前景、预后和并发症的经验。研究结果总结如下：对于无症状的VBD，“观察等待”或药物治疗可能是合理的策略。EVT可能仅对某些患者有效。对于VBD中的囊状动脉瘤，尤其是破裂的动脉瘤，EVT是合理的。对于VBD中的梭形动脉瘤，EVT可能会带来较高的并发症发生率，应谨慎推荐。对于VBD中的支架重建，效果尚不确定。对于VBD的EVT未来发展，随机对照试验和神经介入产品的研发值得探索，但VBD的EVT仍有很长的路要走。
